, Volume 31, Issue 9, pp 1161-1167
Date: 26 Jul 2005

Normalizing physiological variables in acute illness: five reasons for caution

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Introduction

Acute illness is accompanied by the development of abnormal physiology. The development and severity of illness, as well as recovery, is paralleled by changes in the physiological variables that clinicians commonly monitor. Several factors may prompt clinicians to address and treat the variables in isolation from addressing the underlying disease. This article explores why clinicians may target and attempt to normalize abnormal physiological variables and identifies five reasons why such an approach can be hazardous.

Physiological parameters and illness

The evolution of many illnesses usually follows predictable patterns. For example, septic shock, an acute syndrome that is perhaps emblematic of critical care medicine and has a high mortality, commonly follows a foreseeable trajectory from localized to generalized infection, progressive hemodynamic deterioration, multiple organ dysfunction and, in over 30% of patients, death [1]. The cardiovascular changes associated with thi ...

B.P.K. is funded by the Canadian Institutes of Health Research and the Ontario Ministry of Science and Technology.